This Angel is pissed off. I'm Nurse Anne and I work on large general medical ward in the NHS. These are the wards with the most issues surrounding nursing care. The problems are mostly down to intentional understaffing by hospital chiefs that result in a lack of real nurses on the wards.
"The martyr sacrifices themselves entirely in vain. Or rather not in vain, for they merely make the selfish more selfish, the lazy more lazy and the narrow more narrow"-Florence Nightengale

Thursday, 13 January 2011

Wow Peter.....

I think Dr. Peter Carter has actually possibly grown a pair. I think I am turned on. Well, not really.

I wanted to inform you of a very important development relating to the proposals to freeze the incremental pay for all NHS staff in England in exchange for a "no compulsory redundancy" guarantee for some staff.

Today, the RCN rejected the proposals, calling them "illogical" and said they were an "attack upon hard-working nurses". This decision is due to be ratified by Council next week.

The RCN took this decision after hearing the strength of feeling from members who have contacted us by email, via our Facebook page and by post and phone.

Over the past few weeks you've told us how angry you are, you've told us what impact the proposals would have on you and you've said that you want to see the proposals rejected. We listened.

Today, I'm asking you to tell decision makers why your increment matters to you. You can tell us what you think by uploading your thoughts to the new Frontline First video wall.

http://www.rcn.org.uk/frontlinefirstvideowall

Asking you to give up your increments when in return only some would have a guarantee of no compulsory redundancy is, frankly, just not on.

We are also highly sceptical that the Employers would be able to deliver on job security. After all, the RCN's Frontline First campaign has already identified 27,000 jobs earmarked to be cut in the NHS.

Tell decision-makers why your increments are so important and why this proposal was so unacceptable, both to you and the future of patient care. Record your short film today on a mobile phone or webcam.

http://www.rcn.org.uk/frontlinefirstvideowall

The proposals also coincide with the increase in VAT and continuing anger over bankers' bonuses. Nurses and healthcare assistants did not argue against the two-year pay freeze announced last year as you accepted the argument that 'we're all in it together'. However, we fail to see how this is true when bankers are walking away with bonuses (when you bailed them out) and nursing staff are being asked to take yet another pay cut.

Enough is enough.

Yours sincerely,

Dr Peter Carter

Chief Executive & General Secretary

The RCN will be correct if they reject the proposals. We are already working for free much of the time........ in horrid conditions that a private sector employee could never imagine. I am counting the minutes until I return to the private sector myself. Jobs have been going for years unofficially(via natural wastage i.e not replacing retiring, immigrating, sectioned under the mental health act staff nurses).

Not matter how much cash they save it will NEVER EVER HIT THE FRONTLINES. The NHS could have a windfall of 100 trillion pounds. Not one penny would trickle down to the frontlines. Not one. Even if they did save a ton of cash via pay cuts and redundancies we all know that our patients will never see any benefit from that, and neither will we. We will not only be impoverished but we will be the scapegoat for all the patient complaints. We can't function as it is.....

Government is untrustworthy. And we should all be giving the finger to them. They take a lot of money off of us, have always artificially suppressed our wages and do not deliver what they promise for our patients.

All I can say is I am so glad to be leaving the NHS. I have not even been qualified a year and am already at my wits end! Don't get me wrong, I love bedside nursing but I am tired of the horrendous working conditions and complete lack of BASIC resources.

Today I looked after a lady who after vomiting bright red blood (upper GI bleed) required a bp reading. We have no small bp cuff to accommodate her matchstick arms and the manual sphyg has gone walkabouts. This kind of crap is becoming commonplace and sooner or later someone is going to get seriously hurt.

I start as a Dialysis Nurse soon with a private firm and am counting the days!

Anonymous I also spend 3/4 of my shift looking for things. I had a patient that needed a high flow 02 mask. He was so poorly we fast paged the reg and got the crash trolley out. I felt that he was going to go. He was deteriorating before my eyes.

I could not locate a mask. They usually keep them in the treatment room but when I went to look for it there was none.

We have three storage areas all far away from one another on the ward. I ran to the first one in bay one and no 02 masks were in there. The patients in that bay shouted nurse when they saw me enter the bay but I just had to shout sorry can't stop.

Then I moved onto the next closet in another bay. None there. But the patients in that bay all shouted "Nurse I need you" as soon as they saw me. At this point I didn't even know if the patient I left was still breathing and I needed to grab the o2 mask and get back to him.

I found luck in the third storage area. There was one mask left.

The housekeeper has changed the location of everything. Equipment that we would need at all the same time such as green needles, saline bullets and syringes are all far away from eachother. 02 masks and valves are on opposite sides of the ward. I had no bags of dextrose and people on timentin. No nothing. Whenever I leave the ward to cruise around the hospital looking for things I meet other staff nurses from other wards on thr scrounge. I had to give all my IV losec to AAU has they had an emergency and had none. Then I prayed that we wouldn't need any.

Housekeeper also hid the portable 02 sats device (the only one we have on the ward) because she is so sick of "nurses leaving it at a patients bedside". It has to be left at the bedside we have no other way to continously monitor their sats!!! But she hid the damn thing on friday and wasn't back until monday.

I am sick of thicko housekeepers and domestics who think that we are an inconvienece to them.

Have fun in the private sector. They think they are all hard done to over there. But believe me. I have worked in the private sector. It is a treat. Other NHS nurses I know who have worked in the private sector before working in the NHS agree. It is fun.

Anonymous I also spend 3/4 of my shift looking for things. I had a patient that needed a high flow 02 mask. He was so poorly we fast paged the reg and got the crash trolley out. I felt that he was going to go. He was deteriorating before my eyes.

I could not locate a mask. They usually keep them in the treatment room but when I went to look for it there was none.

We have three storage areas all far away from one another on the ward. I ran to the first one in bay one and no 02 masks were in there. The patients in that bay shouted nurse when they saw me enter the bay but I just had to shout sorry can't stop.

Then I moved onto the next closet in another bay. None there. But the patients in that bay all shouted "Nurse I need you" as soon as they saw me. At this point I didn't even know if the patient I left was still breathing and I needed to grab the o2 mask and get back to him.

I found luck in the third storage area. There was one mask left.

The housekeeper has changed the location of everything. Equipment that we would need at all the same time such as green needles, saline bullets and syringes are all far away from eachother. 02 masks and valves are on opposite sides of the ward. I had no bags of dextrose and people on timentin. No nothing. Whenever I leave the ward to cruise around the hospital looking for things I meet other staff nurses from other wards on thr scrounge. I had to give all my IV losec to AAU has they had an emergency and had none. Then I prayed that we wouldn't need any.

Housekeeper also hid the portable 02 sats device (the only one we have on the ward) because she is so sick of "nurses leaving it at a patients bedside". It has to be left at the bedside we have no other way to continously monitor their sats!!! But she hid the damn thing on friday and wasn't back until monday.

I am sick of thicko housekeepers and domestics who think that we are an inconvienece to them.

Have fun in the private sector. They think they are all hard done to over there. But believe me. I have worked in the private sector. It is a treat. Other NHS nurses I know who have worked in the private sector before working in the NHS agree. It is fun.

Anonymous I also spend 3/4 of my shift looking for things. I had a patient that needed a high flow 02 mask. He was so poorly we fast paged the reg and got the crash trolley out. I felt that he was going to go. He was deteriorating before my eyes.

I could not locate a mask. They usually keep them in the treatment room but when I went to look for it there was none.

We have three storage areas all far away from one another on the ward. I ran to the first one in bay one and no 02 masks were in there. The patients in that bay shouted nurse when they saw me enter the bay but I just had to shout sorry can't stop.

Then I moved onto the next closet in another bay. None there. But the patients in that bay all shouted "Nurse I need you" as soon as they saw me. At this point I didn't even know if the patient I left was still breathing and I needed to grab the o2 mask and get back to him.

I found luck in the third storage area. There was one mask left.

The housekeeper has changed the location of everything. Equipment that we would need at all the same time such as green needles, saline bullets and syringes are all far away from eachother. 02 masks and valves are on opposite sides of the ward. I had no bags of dextrose and people on timentin. No nothing. Whenever I leave the ward to cruise around the hospital looking for things I meet other staff nurses from other wards on thr scrounge. I had to give all my IV losec to AAU has they had an emergency and had none. Then I prayed that we wouldn't need any.

Housekeeper also hid the portable 02 sats device (the only one we have on the ward) because she is so sick of "nurses leaving it at a patients bedside". It has to be left at the bedside we have no other way to continously monitor their sats!!! But she hid the damn thing on friday and wasn't back until monday.

I am sick of thicko housekeepers and domestics who think that we are an inconvienece to them.

Have fun in the private sector. They think they are all hard done to over there. But believe me. I have worked in the private sector. It is a treat. Other NHS nurses I know who have worked in the private sector before working in the NHS agree. It is fun.

Anonymous I also spend 3/4 of my shift looking for things. I had a patient that needed a high flow 02 mask. He was so poorly we fast paged the reg and got the crash trolley out. I felt that he was going to go. He was deteriorating before my eyes.

I could not locate a mask. They usually keep them in the treatment room but when I went to look for it there was none.

We have three storage areas all far away from one another on the ward. I ran to the first one in bay one and no 02 masks were in there. The patients in that bay shouted nurse when they saw me enter the bay but I just had to shout sorry can't stop.

Then I moved onto the next closet in another bay. None there. But the patients in that bay all shouted "Nurse I need you" as soon as they saw me. At this point I didn't even know if the patient I left was still breathing and I needed to grab the o2 mask and get back to him.

I found luck in the third storage area. There was one mask left.

The housekeeper has changed the location of everything. Equipment that we would need at all the same time such as green needles, saline bullets and syringes are all far away from eachother. 02 masks and valves are on opposite sides of the ward. I had no bags of dextrose and people on timentin. No nothing. Whenever I leave the ward to cruise around the hospital looking for things I meet other staff nurses from other wards on thr scrounge. I had to give all my IV losec to AAU has they had an emergency and had none. Then I prayed that we wouldn't need any.

Housekeeper also hid the portable 02 sats device (the only one we have on the ward) because she is so sick of "nurses leaving it at a patients bedside". It has to be left at the bedside we have no other way to continously monitor their sats!!! But she hid the damn thing on friday and wasn't back until monday.

I am sick of thicko housekeepers and domestics who think that we are an inconvienece to them.

Have fun in the private sector. They think they are all hard done to over there. But believe me. I have worked in the private sector. It is a treat. Other NHS nurses I know who have worked in the private sector before working in the NHS agree. It is fun.

I echo the previous Anonymous. I can't imagine working in worse conditions. Indeed, in 38 years of nursing I never worked in worse conditions. What you describe week after week is, literally, incredible. How can a housekeeper be allowed to make the decisions you describe in your comment above? On the one occasion in my professional life when I had the services of a housekeeper on my ward she did what she was told. If she'd dared to rearrange the equipment storage without being told she'd have been in serious trouble for interfering in the clinical organisation of the ward.

I agree with the others. Our housekeeper would be read her fortune if she rearranged things. She stocks up, but one of our sisters arranged where everything was to go.

We don't work days and nights in the same week, normally, unless we do 1 short shift and 2 or 3 nights. We do earlies (7-3), late shifts (1-9) or a long day (7-9). We do 4 nights in a week (night shift is 8.30-7.30).

In an atmosphere if universal deceit telling the truth is a revolutionary act. George Orwell.

Why has Nursing Care Deteriorated

Good nurses are failing every day to provide their patients with a decent standard of care. You want to know what has happened? Read this book and understand that similiar things have happened in the UK. Similiar causes, similiar consequences. And remember this. The failings in care have nothing to do with educated nurses or nurses who don't care. We need more well educated nurses on the wards rather than intentional short staffing by management.

About Me

I am a university educated registered nurse. We had a hell of a lot of hands on practice as well as our academic courses. The only people who say that you don't need a brain or an education to be an RN are the people who do not have any direct experience of nursing in acute care on today's wards. I have yet to meet a nurse who thinks that she is above providing basic care. I work with nurses who are completely unable to provide basic care due to ward conditions.
I have lived and worked in 3 countries and have seen more similarities than differences. I have been a qualified nurse for nearly 15 years. I never used to use foul language until working on the wards got to me. It's a mess everywhere, not just the NHS.
Hospital management is slashing the numbers of staff on the ward whilst filling us up with more patients than we can handle... patients who are increasingly frail. After an 8-14 hour shift without stopping once we have still barely scratched the surface of being able to do what we need to do for our patients.

Quotes of Interest. Education of Nurses.

Hospitals with higher proportions of baccalaureate-prepared nurses tended to have lower 30-day mortality rates. Our findings indicated that a 10% increase in the proportion of baccalaureate prepared nurses was associated with 9 fewer deaths for every 1,000 discharged patients."...Journal of advanced nursing 2007

THIS MEANS WE NEED WELL EDUCATED NURSES AT THE BEDSIDE NOT IN ADVANCED ROLES

Dr. Linda Aiken and her colleagues at the University of Pennsylvania identified a clear link between higher levels of nursing education and better patient outcomes. This extensive study found that surgical patients have a "substantial survival advantage" if treated in hospitals with higher proportions of nurses educated at the baccalaureate or higher degree level.

THIS MEANS WE NEED WELL EDUCATED NURSES AT THE BEDSIDE NOT IN ADVANCED ROLES

Dr. Linda Aiken and her colleagues at the University of Pennsylvania's Center for Health Outcomes and Policy Research found that patients experienced significantly lower mortality and failure to rescue rates in hospitals where more highly educated nurses are providing direct patient care.

Evidence shows that nursing education level is a factor in patient safety and quality of care. As cited in the report When Care Becomes a Burden released by the Milbank Memorial Fund in 2001, two separate studies conducted in 1996 - one by the state of New York and one by the state of Texas - clearly show that significantly higher levels of medication errors and procedural violations are committed by nurses prepared at the associate degree and diploma levels as compared with the baccalaureate level.

Registered Nurse Staffing Ratios

International Council of Nurses Fact Sheet:

In a given unit the optimal workload for a registered nurse was four patients. Increasing the workload to 6 resulted in patients being 14% more likely to die within 30 days of admission.

A workload of 8 patients versus 4 was associated with a 31% increase in mortality. (In the NHS RN's each have anywhere from 10-35 patients per RN. It doesn't need to be this way..Anne)

Registered Nurses in NHS hospitals usually have between 10 and 30+ patients each on general wards.

Earlier in the year, the New England Journal of Medicine published results from another study of similar genre reported by a different group of nurse researchers. In that paper, Needleman et al3 examined whether different levels of nurse staffing are related to a patient’s risk of developing complications or of dying. Data from more than 5 million medical patient discharges and more than 1.1 million surgical patient discharges from 799 hospitals in 11 different states revealed that patients receiving more care from RNs (compared to licensed practical nurses and nurses’ aides) and those receiving the most hours of care per day from RNs experienced fewer complications and lower mortality rates than those who received more of their care from licensed practical nurses and/or aides. Specifically for medical patients, those who received more hours per day of care from an RN and/or those who had a greater proportions of their care provided by RNs experienced statistically significant shorter length of stay and lower complication rates (urinary tract infections, gastrointestinal bleeding, pneumonia, cardiac arrest, or shock), as well as fewer deaths from these and other (sepsis, deep vein thrombosis) complications

•Lower levels of hospital registered nurse staffing are associated with more adverse outcomes such as Pneumonia, pressure sores and death.
•Patients have higher acuity, yet the skill levels of the nursing staff have declined as hospitals replace RN's with untrained carers.
•Higher acuity patients and the added responsibilities that come with them increase the registered nurse workload.
•Avoidable adverse outcomes such as pneumonia can raise treatment costs by up to $28,000.
•Hiring more RNs does not decrease profits. (Hospital bosses don't understand this. They think that they will save money by shedding real nurses in favour of carers and assistants. The damage done to the patients as a result of this costs more moneyi.e expensive deaths, complications,and lawsuits, and complaints....Anne)

Disclaimer

I know I swear too much. I am truly very sorry if you are offended. Please do not visit my blog if foul language upsets you. I want to help people. That is why I started this blog and that is why I became a Nurse. I won't run away from Nursing just yet. I want to stick around and make things better. I don't want the nurses caring for me when I am sick working in the same conditions that I am. Of course this is all just a figmant of my imagination anyway and I am not even in this reality. Or am I?Any opinions expressed in my posts are mine and mine alone and do not represent the viewpoint of the NHS, the RCN, God, or anyone else.